by Ben Taylor

Calls for local production of medicine
President Magufuli has argued that the country must build its capacity for local drug factories. “Only 6% of the medicine is produced here… why? We must do something,’’ he said during an event hosted by the Medical Stores Department (MSD) in Dar es Salaam. According to data from the Ministry of Industry, Trade and Investment, Tanzania spends over TSh 800 billion every year on importing medicine and medical supplies.

In response, researchers, investors and government leaders are now trying to answer the question: Can the local pharmaceutical industry recover its former glories?

Industrial players and researchers largely concur that current policy is unfavourable. Mr Jayesh Shah, Group Managing Director of Sumaria Group and former owner of Shelys, one of Tanzania’s largest pharma­ceutical firms, urged the government to “come up with a policy that makes local manufacturing of drugs mandatory, unlike the current one which favours importation.’’

“The cost of production was higher than the profit I was making, that’s one of the reasons I had to move out of the business,” he added. A report published by REPOA, a research institution, in 2014 found that pharmaceutical production had been a Tanzanian industrial success in the mid-90s, but that such former success is now history. By 2014, the industry was in decline, said the report. “There is a lack of active public sector support for local firms as compared to other competing coun­tries,’’ says the report. “It requires a change of mind-set for policy mak­ers in Tanzania to turn to prioritising and actively engaging in selective support of the sector,’’ suggested an academic study published in 2016, Making Medicines in Africa.

Some investors sense an opportunity. Mr Ramadhan Madabida, Managing Director of Tanzania Pharmaceutical Industries Limited (TPIL), says the pharmaceutical demand is USD $550 million per annum, but added that “locally active pharmaceutical industries in Tanzania which produce medicine are still not enough to curb the shortage.”

A report by the Ministry of Industry, Trade and Investment shows that there are 13 pharmaceutical factories in the country, but that only five are currently active and only four are fully licensed.

Mr Madabida says the government needs to work in collaboration with local investors in filling the gap. But, he emphasises that “the govern­ment should formulate policies that enable investors to access funding from financial institutions to encourage more investment.”

“It is important now to think of motivating the local investors through tax incentives and opportunities for borrowing. There is no letter of credit being given to the local investors to enable them access funding from local financial institutions, as compared to foreigners,” he added.

Following the President’s intervention, calling for local manufacturing of drugs, over 10 local investors have expressed an intention to put up local drug factories, according to the Ministry of Industry, Trade and Investment. The Ministry added that the government is now laying groundwork for a National Pharmaceutical Sector Strategy, intended to ease operations for local investors.

According to the Ministry, this strategy will create a 15% price advan­tage for locally manufactured medicines compared to imported medi­cines, develop a list of medicines to be manufactured locally, create a pharmaceutical industrial park and cut taxes on imported raw materi­als.

Activists protest expansion of cigarette production for local market
Executive Director of Tanzania Tobacco Control Forum (TTCF), Lutgard Kagaruki, argued that the opening of Mansoor Industries Limited – an affiliate of Philip Morris International – in Tanzania, is bad news for the country’s health sector as smoking youths will likely fall victim to killer diseases such as cancer.

The company has started rolling out its products under the Chesterfield brand, according to a statement issued by Mrs Kagaruki.

She claimed that more than 2.4 million adults (15+ years) in Tanzania and 17,000 children aged 10-14 years smoke tobacco. “Research at Ocean Road Cancer Institute indicated that 32% of all cancers at the institute were tobacco-related, costing government more than $40m annually,” she added.

Expansion of health service facilities
The government has spent a total of TSh 162 billion (USD $72 million) in recent months on improving 170 health centres, President John Magufuli has said. He was speaking at a function to unveil 181 vehicles – worth TSh 20 billion – belonging to the Medical Stores Department.

Upon completion of the improvement exercise, he explained, the 170 health centres will be capable of performing emergency operations on pregnant women and children as the country seeks to further reduce maternal death and child mortality.

Apart from upgrading the 170 health centres, said Dr Magufuli, the government has also built a 268 more health centres, bringing the total number of such facilities across the country to 7,284.

“This includes construction of regional hospitals in the new regions of Njombe, Geita, Katavi and Simiyu. We are also introducing and improv­ing specialized services in various hospitals in the country,” he said.

Reports of Dengue fever outbreak
The Ministry of Health has confirmed several cases of Dengue fever in Dar es Salaam in early 2018. “11 patients have been diagnosed with the disease,” said the Ministry’s Permanent Secretary, Prof Mpoki Ulisubisya, adding that outbreak control measures are being imple­mented.

He said the ministry in collaboration with the National Institute for Medical Research (NIMR) and local clinics will continue to make diag­nosis to uncover more cases of the disease if any. Surveillance activities will be conducted in the coastal cities of Dar es Salaam and Tanga, according to the Ministry.

The worst dengue fever outbreak in Tanzania occurred in 2014 when more than 400 patients in Dar es Salaam were diagnosed with the disease and at least three died. Dengue fever is said to affect about 390 million people in the world every year, and is particularly prevalent along the East African coast.

There is no medicine or vaccine for dengue, so health experts recom­mend prevention by preventing mosquito bites. Mosquitoes that spread dengue are not the same as those that spread malaria, and bite both during the day and night.

by Ben Taylor

Prize for Dr Malecela
Tanzania’s Dr Mwele Malecela has been awarded the 2017 Kyelem Prize in recognition of her work in combating neglected tropical diseases (NTDs). Dr Malecela, now serving as a Director in the World Health Organisation (WHO) African regional office, was previously director general of the National Institute for Medical Research (NIMR) in Tanzania. She was fired from that position by President Magufuli in December 2016, the day after she told the media there were signs that the Zika virus was present in Tanzania.

Dr Malecela’s prize was received on her behalf by Dr Upendo Mwingira, the NTD programme manager in the Ministry of Health, Community Development, Gender, Elderly and Children. “It’s a real honour to have Dr Upendo receive the award on my behalf! Thanks Tanzania NTD Programme, it’s our collective success!” said Dr Malecela.

The Kyelem Prize is awarded by the NTDs research coalition (CORNTD), a group of researchers, programme implementers and their supporters with a shared goal of optimising elimination of NTDs. The prize is named after the late Dr Dominique Kyelem, a medical doctor from Burkina Faso who worked tirelessly in combating NTDs. (The Citizen)

Innovation in malaria prevention
The London Times recently published an article by Kate Wright about what it described as ‘Trojan cows’ and the worldwide campaign to defeat malaria. A biotech company is going further than the use of nets or insecticides to thwart the mosquitoes that carry malaria from person to person. They have now begun using livestock doused in human scent to lure mosquitoes to their deaths.

In much of East Africa livestock such as cows and goats often live alongside people. These animals get malaria. Mosquitoes tend to prefer sucking blood from humans. A potent cocktail of four or five human odour compounds has now been developed that can be sprayed on to animals so that they can develop their own alluring ‘eau de human’ rather than ‘eau de cologne’.

The concept has been tested on a small scale where researchers conducted experiments in which they go into a greenhouse, and then, together with the goats, face the mosquitos, noting where each one landed. The researchers found that mosquitos were attracted to the goats sprayed with a common worming medicine that also kills mosquitos. The mosquitos can thus be persuaded to bite cows or goats that will kill them and prevent them from spreading malaria. (The Times)

Malaria past and present
A new study has found that the prevalence of malaria in sub-Saharan Africa is at the lowest point since 1900. A team of researchers led by Professor Bob Snow of the Centre for Tropical Medicine & Global Health at Oxford University, spent 21 years finding and analysing data from over 50,000 surveys of malaria prevalence from across Africa.

The study found an overall decline of 24% in the number of children infected with malaria between 2010 and 2015, and a 40% drop between 1900 and 1929.

“Investment in malaria control in Africa has been sporadic in the past,” said Professor Snow. “The world has seen a reduction in malaria over the last 15 years, based largely on the use of treated bed nets and antimalarial drugs. If we take our eye off the ball, then rising drug resistance and falling control will lead to the sorts of increases we saw in the 90s.”

The financial boost provided by the Global Fund has, since 2005, led to one of the largest drops in malaria infection prevalence witnessed. However, gains made after 2005 have stalled since 2010. A decline in funding, coupled with increased insecticide and drug resistance, are the main obstacles to the elimination of malaria in Africa. (The Conversation)

by Ben Taylor

Concern over rising diabetes burden
Experts on non-communicable diseases (NCDs) have predicted that the cost of curbing diabetes in Tanzania and other eastern African countries will increase from $3.8 billion in 2015 to $16.2 billion by 2030. The Lancet Diabetes and Endocrinology Commission on Diabetes in sub-Saharan Africa, say the cost associated with the disease could more than double in sub-Saharan Africa by 2030, with Tanzania, Kenya and Ethiopia especially hard-hit. They say that this is likely to happen if type 2 diabetes cases continue to increase.

“We conclude that sub-Saharan Africa is not prepared for the increasing burden of diabetes brought about by rapid and ongoing transitions,” said the commission’s report. “Effective management of diabetes in sub-Saharan Africa will require careful considerations about the expansion of services to meet current and future burden, while ensuring that services are integrated with those for other chronic diseases. The health, economic, and societal consequences of inaction will be huge. Decisive action is needed now, by all stakeholders, to address the scale and urgency of diabetes in sub-Saharan Africa.”

The report estimates that the economic cost of diabetes in sub-Saharan Africa in 2015 totalled $19.5 billion, equivalent to 1.2% of the region’s GDP. More than half of this economic cost is spent on accessing diabetes treatment, including medication and hospital stays. The remaining economic costs were a result of productivity losses, mostly from early death, as well as people leaving the workforce early, taking sick leave and being less productive at work due to poor health.

Rapid societal transitions that are producing increases in wealth, urbanisation, changing lifestyle and eating habits, more sedentary work practices and aging populations have led to increased risk of type 2 diabetes. (The Citizen)

Tanzania moves to put all people living with HIV on ARVs
TANZANIA officially started anti-retroviral (ARV) treatment for people living with HIV after testing positive effective October last year, with the government announcing that the new arrangement targets 1.2 million victims. The move comes in the wake of a World Health Organisation (WHO) directive in 2015 that any HIV-positive person must immediately be put on anti-retroviral treatment regardless of CD4 count.

The WHO directive followed studies that established that it was safer for patients to start using the drugs before the CD4 count dropped. Previously, Tanzania was applying a system under which only patients whose CD4 cell count had dropped to below 350 qualified for the therapy.

The Deputy Minister for Health, Community Development, Gender, Elderly and Children, Dr Hamisi Kigwangalla, told Parliament that between July 2015 and June 2016, about 84,000 people who had tested HIV positive were enrolled for ARVs treatment.

“We will ensure that whoever is found with HIV, including children and elders, start taking the drugs straightway,” said the deputy minister.

The government also plans to include a new generic version of the antiretroviral drug Dolutegravir (DTG) in the national HIV/Aids treatment protocols. The Minister of Health, Community Development, Gender, Elderly and Children, Ms Ummy Mwalimu, told The Citizen that the ARV had been lined up for registration and licensing by the Tanzania Food and Drugs Authority (TFDA). A generic of DTG, first approved in the United States in 2013, is already in use in Kenya and has the backing of Unitai, the global health initiative working to end tuberculosis, HIV/ Aids and malaria epidemics.

“Shipments are scheduled to start in January 2018 after the TFDA’s registration process is completed,” said the Minister. She added that Tanzania would start using the generic drug in combination with other ARVs. DTG, whose brand name is Tivicay, is produced by ViiV Healthcare, which is majority-owned by British pharmaceutical giant GlaxoSmithKline.

A total of 1.4 million Tanzanians were estimated to be living with HIV in 2015. An estimated 54,000 new infections and 36,000 AIDS-related deaths occur in Tanzania each year. (Daily News, The Citizen)

Government reiterates respect for traditional healers
The Minister for Health, Community Development, Gender, Elders and Children, Ummy Mwalimu, told parliament that traditional healers are legally recognised by the government through the Traditional and Alternative Health Practice Council, 2002. She said that the government has set-up a new registration system for herbalist and traditional healers, where they are supposed to register at their specific localities under the office of the District Medical Officers (DMOs).

The minister was responding to questions from MPs. Joseph Kasheku, Geita Rural MP, expressed concern with the level of education of some of the practising herbalists in the country, and called on the government to come up with an educational plan for traditional healers, especially since many Tanzanians depend on their services. Ushetu MP, Elias Kwandikwa, wanted to know why the government was arresting traditional healers in Ushetu District.

In 1974, the Traditional Medicine Research Unit was established at the University of Dar es Salaam, and in 1989 the government set up a Traditional Health Services Unit in order to unify traditional health practitioners and mobilise them to form their own association.

Traditional health services were officially recognised in the National Health Policy of 1990, and in 2002 the Traditional and Alternative Medicines Act was introduced. (Daily News)

by Ben Taylor

Drone-based deliveries of blood and medical supplies to be trialled

“Zip” drone being tested in Rwanda (flyzipline.com)

The UK government is supporting a trial using drones to deliver blood and other medical supplies to remote health clinics in Tanzania. The idea is to dramatically cut the time spent distributing such supplies. The Ifakara Health Institute will be the local partner.

The drones – known as “Zips” – are small fixed-wing aircraft that are launched from a catapult. They then follow a pre-programmed path using GPS location data. Compared to multi-rotor models, the Zips cope better with windy conditions and stay airborne for longer. In theory, they can fly up to about 180 miles (290km) before running out of power. However, they require open space to land: an area about the size of two car parking slots. These drones will get round this by descending to around 5m when they reach a clinic and then dropping their loads via paper parachutes.

Dfid estimates that flying blood and medical supplies by drone from Dodoma to surrounding clinics could save around £50,000 a year com

pared to using cars or motorcycles. But they add that the time savings are more significant.
“Flights are planned to start in early 2017, and when they do it is estimated that [the] UAVs could support over 50,000 births a year, cutting down the time mothers and new-borns would have to wait for life-saving medicine to 19 minutes – reduced from the 110 minutes traditional transport methods would take,” a spokeswoman explained. “This innovative, modern approach ensures we are achieving the best results for the world’s poorest people and delivering value for money for British taxpayers,” said the International Development Secretary Priti Patel. (BBC)

Kenya turns down Tanzania’s offer of doctors to provide strike cover
The Tanzanian government offered to send 500 medical doctors to Kenya to help overcome the effects of a strike in public hospitals in the neighbouring country. This was despite Tanzania itself facing a serious shortage of medics at its own hospitals.

Kenya’s doctors went on strike in public hospitals on December 5 last year, demanding better pay and working conditions. The strike means that many public hospitals in Kenya have had to turn away some patients, and has reportedly caused the deaths of several patients at public hospitals. It has threatened to undermine Kenyan President Uhuru Kenyatta’s bid for a second term in the country’s presidential election in August, according to analysts.

President Magufuli responded positively to a request from Kenyan President Uhuru Kenyatta for more doctors after he was visited by Kenya’s health minister, Cleopas Mailu, in Dar es Salaam. “Tanzania has accepted Kenya’s request for 500 doctors to help the country deal with a shortage of doctors at its medical centres following a doctors’ strike,” said a statement from the President’s Office.

The Minister for Health, Community Development, Gender, Elderly and Children, Ummy Mwalimu, said Tanzania has “many qualified medical doctors who are currently unemployed.”

However, a section of the medical fraternity in Kenya interpreted the offer as a form of strike-breaking, and responded by strongly hinting that the Tanzanian doctors can expect a hostile reception, triggering fears that the Tanzanian doctors could be thrown into the middle of Kenya’s tense political process and aggressive trade union movement. A court in Kenya then issued an injunction barring the government from recruiting doctors from Tanzania.

The president of the Medical Association of Tanzania (MAT), Dr Obadia Nyongole, reminded the Tanzanian government of the need to address a shortage of doctors in the country’s own medical centres. Tanzania has an estimated 2,250 medical doctors, less than half the number required to meet World Health Organisation minimum standards: the requirement is around 5,000 doctors. (The Guardian, The Citizen)

by Ben Taylor

Zika rumours and denials
The Minister for Health, Community Development, Gender, the Elderly and Children, Ms Ummy Mwalimu, held a hastily-arranged news conference in mid-December to reassure the public that there was no outbreak of the Zika virus in the country. “Tanzania has no Zika patient,” she said.

The statement came just a day after the National Institute for Medical Research (NIMR) released study findings showing that 87 of the 533 people whose blood samples were tested had Zika virus.

“NIMR just reported findings of a [pilot] study on efficiency of a new research device for Zika and Chikungunya viruses,” explained the Minister.

Dr Malecela, the Director General of NIMR, who had earlier issued the report that caused anxiety, accused the media of reporting the matter “inaccurately”. “The findings only showed that there were strains of Zika virus in samples drawn from people in eight regions. There is no Zika patient,” she said. This explanation was deemed insufficient to save her position, however, as she was fired hours later.

Deputy Minister of Health, Dr Kigwangalla, directed NIMR to follow proper channels whenever making sensitive findings to public. “The government has the mandate of announcing the occurrence of any infectious disease. We are aware of the efforts made by the research institutions that focus on complimenting the government commitment to end communicable diseases,” he noted.

An outbreak of the Zika virus in Brazil and elsewhere in South America attracted widespread public attention earlier in 2016. Most cases have no symptoms, but when present they are usually mild and can resemble dengue fever. However, mother-to-child transmission during pregnancy can cause microcephaly and other brain malformations in some babies. The virus is spread by mosquitoes, making mosquito avoidance an important element to disease control. There is no vaccine or treatment currently available. (The Citizen, Daily News)

Drug shortages and debts
The Ministry of Health and Social Welfare took steps to reassure the public that the government would ensure supplies of essential medicines would be maintained, after Sikika, a health-focussed NGO, revealed spending on drugs was well below the budgeted amount.

“These reports (of a medicine crisis) are false and they are aimed as causing members of the public to panic,” Minister Ummy Mwalimu told a news conference. “I would like to assure you that the fifth phase government places utmost priority on health.”

The minister said MSD has the drugs for all the top 10 common diseases in the country, citing malaria, tuberculosis, cough infections, leprosy, polio and antiretrovirals (ARVs). However, she said the government would reform several aspects of the drug supply chain to address supply problems.

The health budget for the current financial year is substantially higher than in previous years, primarily in order to clear a large outstanding debt with the Medical Stores Department (MSD). MSD revealed earlier in the year that the government owed them a total of TSh 145bn, and the Ministry has budgeted to clear the bulk of this debt during 2016/17.
(Daily News, The Citizen)

by Ben Taylor

Health sector budget criticised
Health sector analysts and advocates took issue with the 2016/17 budget of the Ministry of Health, Community Development, Gender, Elderly and Children, as tabled by the Minister, Ummy Mwalimu, in parliament. The budget totals TSh 845bn (£300m), of which TSh 518bn was allocated to development expenditure and TSh 278bn for recurrent costs.

This represents a small overall increase on the Ministry’s 2015/16 budget, which totalled TSh 785bn, but analysts pointed out that under President Magufuli, two Ministries had been incorporated into one, with the Ministry of Health and Social Welfare having been merged with the Ministry of Gender, Women and Children.

The executive director of Sikika, a local health advocacy NGO, Irenei Kiria, said the budget would not help tackle a number of challenges facing the sector including shortage of drugs in health facilities. “The budget is not enough to significantly cut the drug shortage. The minister says TSh 251 billion from the development fund have been allocated to purchase medicine and other medical supplies but we should remember that the ministry also owes the Medical Stores Department about TSh 131 billion,” he said.

Meshack Mollel, the Advocacy and Resource Mobilisation manager for UMATI, an NGO dealing with sexual and reproductive health education, information and services, challenged the government to meet the Abuja Protocol that requires every country under the agreement to allocate at least 15% of its annual budget to the health sector. This means the budget should have been about TSh 4 trillion. “In this budget we should not expect any big things in the health sector,” he said.

Gloria Shechambo of the Tanzania Gender Network Program (TGNP) praised the decision to allocate more funds into development projects than the recurrent budget, but added that the key challenge was the timely release of funds by the Treasury. “The government’s plans to offer to Tanzanians universal health coverage should prompt improvement in financial allocations to the sector, otherwise the plans will remain a far-fetched dream,” she said.

First ever heart bypass survey in East Africa

The operating theatre at JKCI photo www.saveachilds.heart

A visiting team of doctors from BLK Hospital in New Delhi, India, and doctors from JKCI carried out the two-day joint exercise in May 2016, according to Head of the Cardiology Unit at the JKCI, Dr Peter Kisenge. Dr Kisenge told a news conference in Dar es Salaam that in those two days, his institute would help the country to save TSh 180m, the amount that would have been spent if the 18 patients had opted to travel outside the country for treatment.

“Performing a heart by-pass surgery costs TSh 27m for a single patient abroad and if a patient decides to undergo such surgery in Tanzania, he/ she will have to pay between TSh 8m and TSh 10m’’ he said.

The Indian hospital will provide training to doctors from Tanzania in New Delhi, and will regularly send teams from India to Tanzania to work with cardiologists at JKCI and to perform complicated surgeries.

“We are optimistic that the Tanzanian doctors will be able to learn more from us as we will similarly be able to learn as well from them through this partnership,’’ said Dr Subhash Chandra, the Chairman and Head of Cardiology Heart Centre at BLK Hospital.

Previously the JKCI carried out surgery using a heart lung machine that requires cardiologists to stop patients from breathing until the process is completed.

Missed targets on non-communicable disease
Tanzania has failed to meet targets set in 2011 to control and pre­vent chronic and non-communicable diseases (NCDs), according to a new report by the Tanzania Non-Communicable Diseases Alliance (TANCDA).

The missed targets include a 25% reduction in risks of premature mortality from cardiovascular, cancer, diabetes and chronic respiratory diseases, and a 30% reduction in tobacco use.

TANCDA Chairman, Dr Tatizo Waane told The Citizen that Tanzania has failed to meet the targets because NDCs receive fewer resources.

by Ben Taylor

Service Provision Assessment Survey
The National Bureau of Statistics (NBS) has released findings from a new survey of health service provision across Tanzania. Working together with the Ministry of Health, Community Development, Gender, the Elderly and Children, NBS, surveyed 1,188 health facilities, including those owned by private sector and religious institutions as well government facilities.

The survey, the first of its kind since 2006, was designed to collect information on service delivery from a sample of all functioning health facilities, and their preparedness to provide quality services across a range of health needs.

Key findings of the survey include the following:
• The number of health facilities has increased from 5,669 in 2006 to 7,102 in 2014-15. The number of hospitals has increased from 224 to 256, health centres from 541 to 714, and dispensaries from 4,904 to 6,132.

• 81% of health facilities have HIV testing capabilities, including 96% of hospitals.

• Prevention of Mother-to-Child Transmission of HIV is available in all health provision centres.

• Availability of basic child vaccines has improved, with nearly three quarters of health facilities able to provide vaccinations.

• Only one in four facilities offering care for sick children meet the four key readiness standards for proper malaria treatment of diagnostic capacity, treatment guidelines, first line medicine and properly trained personnel.

Mosquito trap developed in Ifakara
A new tool that promises protection from mosquitos for people working and relaxing outdoors has been developed by the Ifakara Health Institute (IHI) in Tanzania. The device has the potential to fill a significant gap in the malaria prevention toolkit – people in outdoor environments where they cannot benefit from insecticide treated bednets or insecticide sprays.

The Mosquito Landing Box emits a human scent along with a small amount of carbon dioxide to simulate human breath. This combination, which is spread by small, solar powered fans, attracts Anopheles moquitos, the type that can carry and transmit malaria. Mosquitos that are attracted to the device are then either electrocuted if a power supply is available or covered in insecticide or deadly fungi.

According to Arnold Mmbando, a researcher at IHI, each scented-bait can last for a month and is not unpleasant to people nearby. Importantly, mosquitos appear to be more attracted to the traps’ scent than to real humans.

The prototype boxes, which cost between US$100 and US$150, can attract mosquitos over an area of 100 square metres.

Steven Harvey, of the Johns Hopkins Bloomberg School of Public Health in the US, said that “right now we don’t have anything that really works outdoors”, but that more testing will be needed before box can be rolled out. “It’s a technologically complex solution, and it will have to be done at a reasonable cost,” he said.

by Ben Taylor

Cholera outbreak prompts unusual response
An outbreak of cholera that begun in August 2015 in Dar es Salaam had claimed 100 lives by early November. The first cases were recorded in Kinondoni Municipality, and it quickly spread to Temeke and Ilala. Over 7,500 cases have now been reported from 39 districts in 17 regions.
To stem the spread of the disease, authorities in Dar es Salaam took steps to improve water quality and hygiene across the city. This included destroying shallow wells and installing new facilities for water tankers to collect water from.

President Magufuli drew on the outbreak to provide a focus for his alternative approach to Uhuru Day on December 9. Instead of the usual national ceremonies and celebrations, he called for the funds to be saved for more important activities and called on Tanzanians to spend the day cleaning up their local environment.

Tanzania certified as polio free
19 years after the last case of polio in Tanzania, the country has been officially declared polio free.

In a statement, UNICEF said that “this achievement in turning the tide against polio is the result of political will and government leadership in the country.” Coordinated efforts with communities comprised routine vaccination at health facilities, and specific efforts in high-risk areas targeting hard­to-reach population. Other approaches included training support to thousands of front-line workers in communities as well as campaigns and polio surveillance activities.

Dr Donan Mbango, the Permanent Secretary in the Ministry of Health said that vaccine coverage had been maintained at 90% nationally, and that polio surveillance will continue. “UNICEF will continue to work with the Government and its partners to ensure all children are reached and are glad to note polio vaccination will continue. We cannot let down our guard, as there could be a re-emergence and we must be vigilant,” said UNICEF’s Deputy Representative in Tanzania, Paul Edwards.

Heart and kidney hospital in Dodoma
A specialist heart and kidney hospital at the University of Dodoma was officially launched by President Kikwete in mid-October. The Benjamin Mkapa Ultramodern Hospital, reportedly the third of its kind in Africa, will also serve as the referral hospital for Dodoma and Singida regions.

Speaking at the launch, President Kikwete said that the facility would reduce the cost of sending patients abroad for treatment. “I am pleased that the plan hatched several years ago of having such a modern facility in effort to improve provision of health services to Tanzanians has become a reality,” he said. (The Guardian)

Progress in child and maternal mortality

New born baby at Muhimbili Hospital, Dar es Salaam (photo Michuzi http:// issamichuzi.blogspot.co.uk/)

A recently released report from the World Health Organisation, UNICEF and others shows that maternal mortality in Tanzania has fallen sharply between 1990 and 2015. The data confirms that Tanzania is making progress in battling maternal and newborn mortality.

“Since 1990, Tanzania has reduced under-five mortality by nearly three-quarters and maternal mortality by more than half,” noted Melinda Gates of the Bill and Melinda Gates Foundation. (Daily News)

Birth registration by mobile phone
Tanzania has launched a nationwide system of birth registration via mobile phone. The system has been established by the government registration agency RITA, UNICEF and the communications company TIGO. The new system, which will be rolled out across the country over the next five years, allows a health worker to send the baby’s name, sex, date of birth and family details by phone to a central data base and a birth certificate is issued free of charge in days.

The country has one of the lowest rates of birth registration in eastern and southern Africa. Only 20% of Tanzanians – and less than one in 10 under-fives – have birth certificates, according to the 2012 census. Parents have to pay TSh 3,500 if they request a birth certificate within 90 days of a child’s birth, or TSh 4,000 afterwards, as well as travel costs.

The government expects to register about a million children under the age of five before the end of this year, and 90% of all newborns within the next five years.

Anna Mbelwa, who gave birth to a baby boy at Mbalizi Hospital in Mbeya Region this month, said the initiative made a big difference. “I was very impressed because it usually takes a long time to get a birth certificate,” said Mbelwa. “It was very inconvenient before since parents had to travel a long distance to the district registrar only to be told their children’s files were missing.” she added. (The Guardian)

by Ben Taylor

President Kikwete confirms commitment to “super-hospital”
PRESIDENT Kikwete has affirmed the government’s intention to part­ner with an Indian hospital, Apollo, to set up a medical centre in Dar es Salaam. This is intended to cater for over 100,000 Tanzanians who travel abroad annually in search of treatment for chronic diseases.

President Kikwete, said the government, through the National Social Security Fund (NSSF), has entered into a deal with Apollo Hospital for the establishment of the centre that will serve primarily those that require surgery.

“With collaboration from the Tanzanian government we are ready to set up the centre and we believe that it is very crucial for the country in the fight against non-communicable diseases with assurance of thorough health services to citizens,” said the Chief Executive Officer of Apollo Hospital, Mr Sangita Reddy.

22 million nets
The government, together with USAID and various anti-malaria organi­zations, has launched a 12-month nationwide campaign to distribute over 22 million long-lasting insecticide-treated mosquito nets.

Miriam Lutz of USAID said after increasing awareness and the use of pesticide nets, malaria infections have been reduced by 50%. Partly as a result of such anti-malaria initiatives, there has been a 28% reduction in mortality rates among children under five.

Dar es Salaam Regional Commissioner Said Meck Sadiki said at the launch that each household registered to receive long-lasting insecti­cide-treated mosquito will be given it free of charge.

by Ben Taylor

President Kikwete to chair global health panel
United Nations Secretary General, Ban Ki Moon, has appointed President Jakaya Kikwete to be chairman of a new global panel to recommend ways to prevent and manage future health crises, taking into account lessons learned from the outbreak of Ebola virus.

The panel will hold its first meeting in early May and is expected to submit its final report by the end of the year to the UN Secretary General for further action as appropriate.

HIV/AIDS
WHO and UNAIDS recommendations emphasise that male circumci­sion should be considered an efficacious intervention for HIV/Aids prevention in countries and regions with heterosexual epidemics, high HIV/Aids and low male circumcision prevalence.

HPIEGO, a non-profit health organisation affiliated with Johns Hopkins University, recently completed a five-year voluntary medical male circumcision (VMMC) project in three regions of Tanzania – Iringa, Njombe and Tabora, targeting those aged between 10 and 49 years.

Conducted in collaboration with National Aids Control Program (NACP), the programme managed to reach out to more than 210,000 adolescent and adult males in Iringa and Njombe Regions, and 220,000 people in Tabora Region.

Dr Wanga noted that the project was a success story of change, innovation and evolution on how the three regions went from being traditionally non-circumcising regions to the majority circumcised in just a few years.

Commenting on the achievements, the Iringa regional medical officer, Dr Robert Mahimbo, said he was grateful to JHPIEGO and to the US for their support. “We hope the US will continue supporting efforts of bringing down HIV/Aids transmission in our region,” he said.

Experts say male circumcision provides only partial protection and, therefore, should be only one element of a comprehensive HIV/Aids prevention package, which includes: the provision of HIV/Aids testing and counselling, treatment for sexually transmitted infections, promotion of safer sex practices, provision of male and female condoms and promotion of their correct and consistent use.